Information from The British Association of Urological

Surgeons (BAUS) about bladder catheters

You have been given this leaflet because you have (or are due to have) a
catheter in your bladder. The aim of the leaflet is to provide you with
information about what this involves.
We have consulted specialist surgeons during its preparation, so that it
represents best practice in UK urology. You should use it in addition to any
advice already given to you.
To view the online version of this leaflet, type the text below into your web
browser:
http://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Catheter.pdf

Key Points
• A catheter is a small tube, made of latex or silicone, that is put into
your bladder to allow the urine to drain out
• It is put in either through the waterpipe (urethral catheter) or
through the lower part of the tummy (suprapubic catheter)
• The outside part of the catheter is often connected to a bag, so the
bladder is kept empty; the bag is worn on your leg or around your
tummy.
• The outside part of the catheter can also be connected to a valve
instead of a bag; this means the bladder can fill as it would
normally, and can be drained by opening the valve.
• The bags and valves should be changed every week
• The catheter should be changed at least every 3 months
• Common problems are blockages, pain and recurrent infections,
but most people manage well
• Drainage bags, tubing and other items of equipment will be
provided for you on prescription from your GP
• It is inevitable that you will get bacteria in your urine but this does
not need treating; you only need antibiotics if you have symptoms
of infection
• If you do have problems, your district nurse or GP can usually
resolve the issues for you

Published: April 2017 Leaflet No: 16/004 Page: 1

Due for review: April 2020 © British Association of Urological Surgeons (BAUS) Limited
What is a catheter?
A catheter (pictured) is a soft, flexible tube that
is passed through your urethra (waterpipe) into
your bladder to drain urine. Sometimes, a
catheter is passed through the lower abdomen
(tummy) instead of the urethra. This is called a
suprapubic catheter.
Your catheter is connected to a bag that straps
to your leg or around your abdomen. The bag
fills with urine, keeps your bladder empty and
can be emptied when full. The catheter may
sometimes be connected to a catheter valve which means there is no bag,
and your bladder will gradually fill with urine. When your bladder is full,
you can release the valve to drain the urine out. This has the advantage that
you do not need to wear a drainage bag.
Different types of catheter are made from different materials, including
latex. If you have any history of latex allergy, please let your doctor or
nurse know. They will then use a latex-free catheter.
Your catheter may feel strange at first, and you may feel very conscious of it.
At first, you may have a constant desire to pass urine, even though your
bladder is being emptied continuously by the catheter. This is not unusual
and usually settles very quickly. It happens because your bladder tries to
push the catheter out by contracting and going into spasm. Your bladder
soon learns to tolerate the catheter, and this constant urge to pass urine
disappears.

How should I look after the catheter?

Your catheter should be treated as a part of your own body and needs to be
kept clean in the same way. You can wash it each day with warm, soapy
water, when you take a bath or shower.
With a catheter in place, you need to drink plenty of fluid to help prevent
urine infections. If your urine becomes dark, this may mean you are not
drinking enough and you should increase your fluid intake.
You should take care not to kink or compress the catheter tubing. Do not
raise the drainage bag above the level of your bladder as this will stop it
draining.
Once your catheter is in place, the nurses looking after you will show you
how to empty it and look after it. They will also give you spare catheters

Published: April 2017 Leaflet No: 16/004 Page: 2

Due for review: April 2020 © British Association of Urological Surgeons (BAUS) Limited
and bags. They will keep in touch with your GP and your district nursing
team. Once your GP has been alerted, you can get any additional items you
need from your local chemist with a GP prescription. Your team will also
give you details of who to contact if you have any problems with the
catheter.
The different parts of the catheter are:
The catheter itself
You do not need to do anything to the catheter, apart from keeping it clean
by washing yourself and the catheter daily. You should dry yourself gently
and thoroughly to prevent any soreness. If you do notice soreness where
the catheter goes in, let your nurse know so you can get advice about how
to relieve this.
The leg-bag for daytime use
This is attached directly to the end of the catheter and collects all the urine
you produce during the day. It will become heavier as it fills. Do not let it
get too full or it will pull on the catheter and cause pain, bladder spasm or
even catheter displacement.
Always wash your hands before and after emptying your drainage bag into
the toilet or a urine bottle. Leg-bags may last up to seven days, after which
they should be replaced.
The leg-bag support
This is rather like a footless sock and is used to keep your leg-bag securely
attached to your leg.
The G-strap (pictured right)
This stops your catheter from being pulled out. It
has a Velcro strap which goes around the catheter
and your leg, holding the catheter firmly in
position.
The night drainage bag
A larger night bag (pictured right) connects
directly to your leg-bag at night without
disconnecting it from the catheter. It holds more
urine than your leg-bag, so you should not need to
empty it during the night.
To connect the night drainage bag:
• remove the leg-bag support;
• wash your hands carefully;

Published: April 2017 Leaflet No: 16/004 Page: 3

Due for review: April 2020 © British Association of Urological Surgeons (BAUS) Limited
 • empty the leg-bag and, with the tap still open, push the end of the
night bag into the tubing below the tap to form a direct route for
urine into the night bag;
• attach the night bag to its stand on the floor by the side of your bed;
and
• in the morning, turn off the tap at the bottom of your leg-bag,
disconnect the night bag and empty it into the toilet. The night bag
can then be discarded or rinsed with warm water to be used the next
night. Your nurse will advise you about this.
We normally give you a small supply of leg and night bags when you go
home. If you need to dispose of a bag, rinse it out with water, put it in a
plastic bag and leave it with your normal household waste. Your GP will
continue to prescribe your new bags and other equipment.
What sort of problems can occur at home?
Some problems may occur with your catheter but your district nurse, GP or
nurse practitioner can advise you on what to do:
Bladder spasms
Bladder spasms feel like abdominal (tummy) cramps. They are usually
caused by the bladder trying to squeeze out the balloon that holds your
catheter in place. If spasms are causing you distress, your GP can prescribe
a drug which helps relax your bladder.
Leakage around the catheter
This is called “by-passing”. It is sometimes caused by bladder spasms (see
above) or can happen when you open your bowels. It can also happen if
your catheter is blocked and stops draining (see below).
Blood or debris in the urine
Debris causing cloudy urine is inevitable and is commoner the longer a
catheter has been in your bladder. It can sometimes block the catheter. If
this happens, you should contact your catheter nurse or GP.
If you see blood coming through your catheter, contact your catheter nurse,
district nurse or GP. It is usually due to infection but, if not, you may need
further tests to work out why it is happening.
Blockage
This can cause a lot of pain and needs urgent attention. Check that your
drainage bag is below the level of your bladder (the lower part of your
tummy), that the catheter and tubing are not kinked or twisted, and that
there are no clots or debris in the catheter. If the catheter will not unblock,
and no urine is draining, contact your district nurse or GP immediately.

Published: April 2017 Leaflet No: 16/004 Page: 4

Due for review: April 2020 © British Association of Urological Surgeons (BAUS) Limited
Catheter falling out
If your catheter falls out, contact your district nurse or catheter nurse
immediately so it can be replaced. If this keeps happening, your GP may
refer you to a urologist for further advice.
Urine infection
You will always have bacteria in your urine if you have had a catheter for
more than a few days. This does not mean you have a urine infection, and
you do not need to take antibiotics. Antibiotics are only needed if you
develop symptoms of a urine infection.
If you have symptoms (a high temperature, a lot of bladder discomfort, a
painful urethra), you should contact your district nurse, catheter nurse or
GP. They will decide whether you need antibiotics and may send a urine
sample for laboratory testing.

What should I do with this information?

Thank you for taking the trouble to read this information. Please let your
urologist (or specialist nurse) know if you would like to have a copy for
your own records. If you wish, the medical or nursing staff can also arrange
to file a copy in your hospital notes.

What sources have we used to prepare this leaflet?

This leaflet uses information from consensus panels and other evidence-
based sources including:
• the Department of Health (England);
• the Cochrane Collaboration; and
• the National Institute for Health and Care Excellence (NICE).

It also follows style guidelines from:

• the Royal National Institute for Blind People (RNIB);
• the Information Standard;
• the Patient Information Forum; and
• the Plain English Campaign.

Published: April 2017 Leaflet No: 16/004 Page: 5

Due for review: April 2020 © British Association of Urological Surgeons (BAUS) Limited
Disclaimer
We have made every effort to give accurate information but there may still
be errors or omissions in this leaflet. BAUS cannot accept responsibility for
any loss from action taken (or not taken) as a result of this information.

PLEASE NOTE
The staff at BAUS are not medically trained, and are unable to answer
questions about the information provided in this leaflet. If you do have
any questions, you should contact your urologist, specialist nurse or GP.

Published: April 2017 Leaflet No: 16/004 Page: 6

Due for review: April 2020 © British Association of Urological Surgeons (BAUS) Limited